GOVERNMENT OF GUJARAT Submit Date : 17/01/2025

Application No:
Umbrella Scheme for Education of ST Students Post-Matric 242500000002001444
Scholarship
Fresh Application

Student Basic Details

Name of Student : gamit sahil amit

Name of Student (As per Aadhar) : Gamit Sahilbhai Amitbhai
Mother's Name : Chandrakalaben
Date of Birth : 05/11/2005 Gender : Male
Category : ST(7ȵkɅl‡ISKWĤiS  Religion :Hindu
Caste : Gamit Fhi\S 

Aadhaar Status Verified: Yes(08/12/2024 22:24:56)

Ration Card No. : 122007007776569 Ration Card Member No. : 122007007776569006

Name As Per Ration Card: (Gamit Sahilbhai Amitbhai / Fh\jSdhˆe_[h:7i\S[h:
EKYC Status As Per Ration Card: Yes EKYC Date: 05-09-2024
Aadhar Number Matched With Ration Card: Yes
Consent Status: I hereby give my consent to use my personal data available with food and civil supply department. I hereby give my consent to
government of Gujarat for fetching my identity for the purpose of post matric scholarship.

Annual Income of Parents/Guardian/Husband (Rs): 70000 Habitation Type: Urban

Mobile Number : 9727802264 E-mail Address : sb553338@gmail.com
Aadhar No : 83xxxxxx4603 Parent/Guardian occupation: Agriculture(EpSj
Is Orphan: NO Day Scholar / Hosteller : Hosteler
Marital Status : Unmarried Hostel Type: Private Hostel

Current Address: Permanant Address:

State Gujarat State Gujarat

District Gandhinagar District Surat

Taluka Gandhinagar Taluka Mandvi

Village Village Rataniya

PinCode 382024 PinCode 394360

Address:Ananta boys hostel, sector 25 plot 193 , gandhinagar , Address:at post rataniya ta mandvi dist surat
Gujarat

Student Bank Account Detail/Aadhar Bank Detail

I voluntarily give my consent to use my Aadhaar details.
Aadhar Number : 83xxxxxx4603 Bank name : -
NPCI Date : 1/17/2025 12:00:00 AM NPCI Status : Accept
I am giving my consent for payment of scholarship amount in my bank account, linked with Aadhar.
Account No : 93xxxxxx1999 IFSC Code : BARB0DBTARS
Student Name(As per Bank Name): sahil amit gamit

Name of Bank : BANK OF BARODA

Branch Name & Address : TARSADABAD

I hereby accept that
1.Details provided by me are correct to best of my knowledge

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 2.Shall not make any claims if amount is transferred to a wrong account due to incorrect details provided by me
3.Shall refund the amount transferred to someone else¶s account due to incorrect details provided by me
4.I will refund the excess amount credited to my account, if any.

Student Academic Details

Present Course/Class/Trade Type: Para medical

Present Course/Class/Trade Name : B.Sc(Nursing) Bachelor Of Science In Nursing

Present Course/Class/Trade Year : 1ST YEAR(1st Semester/2nd Semester)

Studying in : Gujarat Enrollment No:

Present Institute District : Gandhinagar Present Institute : ANANTA INSTITUTE OF NURSING

Admission Type : Regular Paid Seat (Self Finance) Present Branch Course : -

Present Class Start Date : 21-Oct-2024 Present Course Completion Date : 30-Sep-2025

Fees Amount
Admission Fees (Rs) 0
Tution Fees (Rs) 90000
Misc.Fee(NonRefundable Fees) 25000
Exam Fees(Rs) 2500

Total (Rs) 117500

Educational Break : No No. Of. Year in Break :

Are You Employed in any Organization/Establishment with leave without pay? : No

Previous Education Detail

Course/Class/Trade Type Course/Class/Trade Name Branch Name Seat No Passing Year Percentage
9th Std/10th Std 10TH SSC B2181779 2021 83.33

11th Std/12 Std 12TH HSC B294393 2024 55.47

Disablity Detail
Is Disability : No Type of Disability : -

Percentage of disability : - Required Guide/Coaching Guide: No

Guide Name: -
Guide Address: -

List of documents which you have attached :

1 Caste Certificate From the Competent Authorities

2 First Page Of Bank PassBook/Cancelled Cheque

3 Fee Receipt of Current Course Year

4 Self Attested Certificate of Previous academic marksheet

5 Income Certificate From the Concerned Authorised Authority/Persons

6 Hostel Certificate(Only For Hosteller Student)

7 Std:12 Marksheet(If Any)

8 Identity Card (College/School)

I have read all above terms and conditions and understand them fully, I hereby declared that here I am submitting only one
application for scholarship and I haven¶t received any other scholarship/stipend or fellowship in this current session under any other
central/state government scheme. I further state that all information furnished by me is correct to my knowledge in case of any the
false information or suppression of necessary data proved in my application is liable to get cancelled at any stage of the scholarship
process and the entire amount of scholarship will be refunded by me or recovered from me. Government decision shall be final and
binding on me.

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Date : 17/01/2025

Verify Mobile Number : Yes 17/01/2025

Place : Signature of the applicant

It is certified that the information filled in the above mentioned fields by the students are correct to the best of my knowledge and
all the Documents has been checked.

It is also certified that in case the applicant leaves institution or otherwise discontinues the studies or detained or accepts any other
regular scholarships/stipend/ fellowship the fact will be immediately reported to the said authority

Certified that the student is eligible for scholarship amount subject to Central/State government rules and the student is
recommended for sanction of scholarship.

This is to certify that student has regularly attended classes and maintained minimum attendance criteria till date for the A.Y. 2024
-2025. If student will irregular, than we will immediately reported to the said authority.

The actual School/College/University year began on __________________ and will be ended on _____________________

Signature Of Head Of The School/College/Institute/University With Official Seal

Place :

*Note : Stamp Signature will not be accepted

Date :

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